HomeMy WebLinkAbout08010083 Applicationkkr
`?? City of CarmellClay Township Permit
' COMI4IERCIAL/INSTITUTIONAL/MULTI-FAMMY IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF NAME: PHONE: FAX:
OTrd S `f -19,16 aQ''?- ?l
RECORD: STREET ADDRESS: CITY: , STATE: ZIP:
2 s- U L .tJ 6 l"O A() rtJ / 1$ AI - 4( r Z 1
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY
OWNER ? ? PHONl<: FAx:
(a 27-X81 S?-VG $
:
STREET ADDRESS: CITY: STATE: ZIP:
-5,/ d(b{7 L t--il ' ?% ) 4 1V . 12-0
LOCATION ADDRESS or CONSTRUCTION: ?1 y 2Jr SUITE #: (If Applicable) ?s
.
& PROJECT 9
11
INFO: Address of Shell Buildirg: (If different t)an Address of Construction) Lot # and Subdivision: (If Applicable)
B ILDING, PRDIECT, OR TENANT NAME: ZONING: TAX MAP PARCEL #:
STATE COMMERCIAL
DESIGN RELEASE #: 3 r SCOPE(S) OF FDN ? STR ;K ARCH iC MECH L< PLUM
RELEASE: ilk ELEC M-SPKLR OTHER(S): SQUARE
FOOTAGE: i?
WATER UTILITY SEWER UTILITY ESTIMATED COST OF CONSTRUCTION: yff C3
PROVIDER: C/C?iRRh 04- PROVIDER: C Q ?Vlc [_ (EXCLUDING LAND VALUE) 3 S1 od
PLAN COMMISSION J BZA / BPW DOCKET NUMBER5; ANDJOR
COUNTY WELL AND/OR SEPTIC PERMIT *S (If Applicable):
it of Flom: Elevator or Lift: :3 YES X NO 3LDG. CON STRUCTION TYPE: 1.109) OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUgMN_: TYPE O F IMPROVEMENT:
' COMMERCIAL O NEW STRUCTURE
(Privately owned hospitals and medical O ADDITION
officesloenters are commercial) ? Room(s)
O INSTITUTIONAL O Porch
O Municipal/Public Bldg U Mezzanine or Deck
O School REMODEL
O Church C-1 NEW TENANT FINISH
C N1UImi7F14MILY `^ M ` "DWG 0 ACCESSORY BUILDING
Nurt"r of units: E? , .DETAC <D GARAGE
FOUNDATION TYPE: (Check all whidf (?.. ATTACHED GARAGE
apply for the new construction area) CELL TOWER (New)
t CELL'
TOWER CO-LOCATE
SLAB ?. CPAWL SPACE O DEMMM9N
? P057 & _BEAM -PIER: ? 13ASEMENT (WALKOUT: Y-N)
Early Release Manufactured
Permit: ?Y --X-N Trusses: Y -)?-N
Lot Split: Y X,N Sump Pump: ,Y A N
FLOOD ZONE AREA DESIGNATION(S) FOR TH
r;su-
?i a
PLUMBING CONTRACTOR:
Plumber's Indiana State License #: 4
106 W 7(e
Class I structure permits are subject to the General Admi nictrath e- Rules of the State of Indiana (See 475 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree char any construction, reconstruction, enlatgcment, relocation, or alteration of a structure, or any chanh in the use of land or sa-um es requested by
this application will comply with, and conform to, all applicable laws of rye State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1493" (Z- 2139) and a_nendroCns,
adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I furher cerr ly that only, kitchen, bath, and floor drains are
connected to the sanitary sewer. 1 further certify that the construction w ill not he used or occupied until a Certi6cste ofOeeup?iwcyocSrrbscanda/Completioahas (teen
issued Department of Community Services, Carmel, Indiana-
,-?1r SS d! / d
Signatilike of Ow r Authorized Agent Print Date
***?******?***?r******************************************************?**
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: L d 1)
Q Upper Footing O Lower Footing
O Under-Slab Rough-in
Q Meter Base Final Building
D Final Forestry Final Fire Dept.
*NOTE: Above ceiling/grid inspection requirements will be
11 'ndicdted o your permit pia rd.
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Reviewed/ proved: Dept. of Community ServiC (Da )
S,Permits1Fcrmsi1LP COMMERCIAL Aug.2007
# Charged Re-
Ise Inspections: i L) Reviews
Cert. of OCCUp?ncy: do
TO 10 ( Additional Fees
2
F- Ra^p!vM by Date